Hemorrhage Read online

  Hemorrhage

  Medicine and Magic Book 4

  SA Magnusson

  Copyright © 2018 by SA Magnusson

  Cover art by Rebecca Frank

  All rights reserved.

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  Contents

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Author’s Note

  Also by SA Magnusson

  1

  The sight of blood no longer bothered me the way it once did. Not only had I been around it often enough in the ER to no longer feel squeamish about it, but in the time that I’d been using my magic more openly, I’d inflicted a certain amount of bloody damage myself. Still, there was something about having it pulsing out of an open wound that unsettled me more than a little.

  It might be that the steady creep of death began to work along my spine. The longer we were at this, trying to save this patient, the more the sense of cold continued to work up my spine. As much as I might be tempted to use magic—and I was—I couldn’t.

  Bright surgical lights glowed overhead, pushing away everything else around us. I barely registered the surgical technicians or the anesthesiologist, keeping my focus on the patient.

  The patient was young. Hispanic, maybe late teens but looked even younger. The tattoos on his arms looked to be done at home, and the massive cross over his chest must have taken days—and been incredibly painful. If he survived, the scar would forever distort that ink.

  “Pressure here, Dr. Michaels.” Dr. Darnold had a hard way of speaking, something not altogether unique for a trauma surgeon. Blood splattered his blue surgical gown and a hint of sweat trailed down his cheeks.

  Moving the gauze pad off to the side, I placed pressure on the abdominal incision, trying to keep the surgical field exposed. Dr. Darnold continued to suction the blood flowing from the wound, but we hadn’t reached the source yet. Much longer, and we wouldn’t be able to find it.

  Dr. Darnold had a steady hand, dissecting through muscle and fascia as he worked quickly to expose the abdomen. The stench from the electrocautery was something I couldn’t shake and was thankful this was only a one-month rotation, and near the end. It might have been better for Dr. Darnold—and the patient—had he asked for one of the surgery residents to scrub into the case with him rather than me. I was no better than a medical student.

  Every so often, he would pause, and I had learned that was for me to shift where I was holding so he could get a better handle on the tissue. “Suction,” he said and the surgical tech handed him the device. “Damn.”

  “What is it?” I shouldn’t speak up—residents weren’t allowed to question Dr. Darnold—but that didn’t suit me and I was curious. The kid had been shot in the belly twice. The amount of bleeding I’d seen on the ultrasound had indicated a significant injury, but getting in to it had proven difficult.

  “The bullet sheared his renal artery.” His hand remained almost perfectly still as he contemplated his next move.

  The first time I’d seen him operate in a trauma—a three-car pileup that had lacerated a guy’s spleen—he had done the same thing. At the time, I had thought that he wasn’t sure what to do, that maybe his hesitation came from ignorance or uncertainty, but I’d come to realize it was a contemplative move. By hesitating, even if only for a moment, he was able to come up with his next steps and operated that much faster because of it.

  “Call vascular,” he said.

  He continued to cauterize, trying to stabilize the wound. The longer he worked at it, the clearer it became to me that he wouldn’t be fast enough to save this kid. The cold along my spine was a painful sensation. Even without the sense of cold, there had been too much blood loss. There was only so much we could squeeze back into him.

  Honestly, seeing how quickly blood pulsed from the wound left me surprised EMS had managed to get him here in the first place. It was a wonder they had gotten to the hospital with a chance for survival.

  Vascular wouldn’t get here in time to make a difference.

  There was something I could do that would make a difference, but I wasn’t sure how to do it with so many people around and watching. Dipping into my magical stores wasn’t as difficult as it once had been, and I still didn’t have very fine control over it, but enough that I thought I could help.

  Doing so risked exposing me. It would be difficult to use magic in a way that wouldn’t draw the wrong kind of attention or questions about how the guy healed himself. There had been enough strange cases of that at Hennepin General over the last year or so because of me that I couldn’t afford to bring even more focus in my direction. But if I did nothing, there was no question the guy wouldn’t survive. Dr. Darnold might know that from his surgical experience, but I could feel it with a certainty I’d come to trust.

  How could I do nothing? Wasn’t that the point of my training?

  Trying to keep my focus on what was asked of me, I reached for my magic. The sense of it came slowly, pulled up from a deep place inside of me.

  For so many years, I’d buried my magic, fearing it. I still feared it, but for different reasons. No longer did I think I might be a dark mage, someone the mage council would seek out and destroy, burning off my magic. I wasn’t a dark mage, and the mage council now had a treaty with those they called dark mages on the Dark Council.

  There were no spells for what I did. If there were, this might have been easier. Instead, I focused on the power, letting it course out of me, into the patient, flowing from my gloved hands and down into his flesh. Touch—physical contact—seemed to make a difference with this sort of magic.

  Cold surged along my spine.

  There wasn’t much time left.

  “Suction,” Dr. Darnold said again, his voice distant.

  I tried to keep part of my focus on the task in front of me, needing to stay connected to what he was doing. If I didn’t, he’d blame me when the patient died, even if it wasn’t my fault.

  The magic flowed out of my hands.

  I tried directing it, controlling the effect, but with my magic, there wasn’t much in the way of control. I could create barriers and use it to blast my enemies, but attempting more control than that had proven a challenge.

  “What the fuck?” Dr. Darnold snapped.

  I looked over. His cautery had shorted out.

  “I need another cautery. Quick. He doesn’t have much time. And where the hell is vascular?”

  “I paged them to the OR STAT,” one of the techs said.

  Dr. Darnold turned his back to the patient for a moment.

  That would have to be my chance.

  I focused on the wound.

  Having seen the ultrasound, I knew generally where to find his injuries, and I focused my magic there. In the months since I had started using my magic a lit
tle more openly, I’d learned that the key to combining magic and healing had to do with intent. As I couldn’t use a spell the way mages like my grandparents could, I needed to hold onto the intent of the way I wanted my magic to work.

  Most of the time, I didn’t really have much intent. When facing demons or the gorgon or the Great One, I had needed power more than anything else. I’d simply unleashed it, letting that power slam into the creatures. While in the ER, I had often used my magic to allow me to better evaluate my patients and determine where to focus my effort. There hadn’t been many times where I had actually tried to use my magic to heal.

  What better time than now, when the patient was going to die if I did nothing?

  Seal off the arterial injury. That was the first thing that needed to be done.

  Warmth flowed from my hands.

  I glanced over at Dr. Darnold. He was still dealing with the broken cautery. That had been my magic, I was sure of it. When I drew on too much power, there was always a strange effect, regardless of how careful I might try to avoid it. Like the time I’d shorted out the computer in the resident lounge. I still hadn’t understood why that should happen, only that it had before. Destruction followed my magic.

  The cold along my spine remained, a constant presence that continued to push along my back, though I couldn’t tell if the intensity within it was any less than it had been before.

  Death could be reversed, but it was difficult, especially when it was so far along like it was now. I don’t know that I’d ever managed to reverse it in someone not connected to the magical world when I felt it so strongly.

  Maintaining my focus, I continued to let my awareness of the injury flow from me.

  A sense of emptiness crashed into my magic. That was the injury. Could I repair it?

  When I’d used magic to heal before, I had done so with a shifter, a creature who had magic of his own. Then I’d only needed to stop the injury and allow him a chance to recover on his own. With this, it would take my magic.

  And I didn’t have much time.

  I didn’t dare look over at Dr. Darnold, not wanting to see what he was up to. The moment he realized that I wasn’t doing what he expected, he would snap and it would distract my focus.

  Could I seal this emptiness off?

  That was the kind of magic I thought I might be able to do. It was a barrier, nothing more than that, and when I used magic in that sort of way, it was familiar.

  Another surge of warmth flowed from me, wrapping around the emptiness.

  As it did, the cold along my spine eased.

  “Dr. Michaels?”

  I couldn’t pull my attention away. The magic needed another moment. Nothing more than that.

  “Michaels?”

  The voice came from somewhere else. I ignored it.

  Another pulse of power and the warmth sealed off. The emptiness—whatever that represented—trapped within.

  “Why the hell are your hands inside my patient?”

  Looking over at Dr. Darnold, I realized that I had moved during the use of magic. Rather than retracting as I had been instructed, I was now wrist deep in this guy’s belly, my fingers wrapped around a thick, pulsating artery.

  Shit.

  “I was holding pressure like you asked,” I said.

  Dr. Darnold elbowed me off to the side, and rather than holding on and risking disrupting things even more, I quickly withdrew my hands, holding them above the man. “You were asked to hold skin pressure, nothing more. Now what have you done?”

  He leaned forward, staring at the wound a moment, his brow furrowing. I waited for the yell, but it never came.

  “Cautery,” he snapped.

  He continued to work and I stood off to the side, waiting for him to turn his attention to me, but he never did. As he worked, the sense of cold began to retreat. Along with it went the nausea that came with death. It wasn’t as pronounced this time, though I didn’t know if that was because I had intervened in time or whether it was because I had somehow drawn upon the power of death while saving the patient.

  The door to the OR room opened and a tall, slender woman entered. I didn’t recognize the vascular surgeon, but that wasn’t altogether uncommon. A surgical resident trailed her. Dr. Nate Schneid was a solid man, enormous, and an ex-football player. We’d gone to medical school together and I knew him to be serious but skilled.

  “Step back and let Dr. Andrews access the field, Dr. Michaels,” Darnold said.

  I backed away, holding my hands in front of me.

  “What’s the case?” Nate whispered. He was taller than me by nearly a head, and he craned his neck to get a better view.

  “GSW to the belly. Kidney laceration. Arterial involvement,” I answered.

  “Christ. How did he make it here alive?”

  “Fast EMS response. Lots of fluids. And it was luck that we were down in the ER consulting on another case.”

  “This looks pretty clean, Sam,” Dr. Andrews said. I perked up, leaning forward to listen but struggling to get much of a view. Getting pushed back from the table had advantages—I wasn’t tempted to use my magic in ways that I shouldn’t—but it made it much more difficult to know what else was taking place. Had the magic I’d used really helped? It had to have done something, especially as I didn’t feel the same sense of death. “I don’t see anything for me to repair.”

  “The ultrasound showed a pretty significant injury, Aubrey.”

  “I don’t know what to say. I’ll keep looking, but I’m not going to cause problems.” From my vantage, I could make out how she made a few more movements before shrugging. “I say close him up and keep him on close observation. How many shots did he take?”

  “Two to the belly.”

  She sniffed. “Must have someone watching over him.”

  She stepped back and started peeling off her gloves, motioning to Nate to follow.

  “Later,” he said.

  I nodded and returned to the side of the table. Dr. Darnold was already beginning to close things up, working quickly through the muscle layer.

  “The damnedest thing,” he muttered while working. When he finished with the muscle layer, he looked up at me. There was a question in his eyes, but I doubted he’d ever ask it. There was no reason for him to think there was any other explanation. There were enough times when odd and unexplainable things happened in medicine that I doubted he would ever jump to questioning my role in what had happened. “You know how to close the surface layer?” he asked.

  I nodded. Suturing was something I had plenty of experience with in the ER.

  “I’m going to let his family know he’s still among the living.”

  He stepped away and I got to work suturing. As I did, I couldn’t help but feel as if I had done something good by saving the guy. When I finished suturing and placing a dressing, I made my way out of the OR, looking for Dr. Darnold. I found him in the surgery waiting room, talking to what looked to be the patient’s family. They were sobbing and nodding. An older woman clutched a rosary, her head bobbing as she listened.

  On the other side of the waiting room, another pair watched. They sat quietly, leaning on the edge of their chairs, but I couldn’t shake the sense that they were watching. One of them looked to be a little older than me, with dark hair and an olive complexion. He sat almost rigid, hands on his lap. The other was a smaller guy, probably no more than eighteen. One hand was in his pocket.

  When Dr. Darnold turned away, the smaller guy started to get up.

  I caught a glint of metal.

  A gun.

  Crap.

  Magic flowed from me and I wrapped it around both men. They fought, straining against the spell, eyes bulging. I could hold them, but for how long?

  There might be a better way to handle it.

  The smaller guy had to have a gun, and if he did, it stood to reason the larger guy did too. I’d seen something like this before where gang members would come into the hospital to ensure their targe
t died, but I’d never heard of them coming to the OR for the same reason.

  My magic had a variety of uses, and something like this was far more familiar to me.

  Pushing out with a spell, I slammed it into each man while still holding them confined. The effect would be something like a punch to the head. Enough to knock them out, nothing more than that, and then I could release them.

  The smaller man sagged. Only my magic holding onto him kept him from falling to the ground. The larger man remained upright and his eyes narrowed. A soft trail of cold suggested magic, though a weak spell.

  Could he have some access to magic?

  “Dr. Michaels. It’s time to get going,” Dr. Darnold said.

  I nodded, not taking my focus off the other guy. With another blast of magic, I slammed it into his head again. This time, his head bounced off the side of the barrier holding him in place. He blinked, but that was it.

  Either he was tougher than I realized or he had a barrier of his own in place.

  With another blast, I struck him again.

  This time, he went unconscious.

  When he sagged forward, I released the barrier holding them.

  Both men tumbled forward out of their chairs, collapsing on the floor.

  I breathed out a sigh.

  “What the…? Help!” someone called from the side of the waiting room.

  Dr. Darnold jerked his head around and hurried over, leaving me to follow. Fatigue washed through me, though I didn’t know if it was from using the spell or from fear of getting caught. Both were exhausting.

  “What happened here?” Darnold said. He crouched down, starting to examine the shorter of the two, when he froze. “Call security,” he said, glancing over at me.

  I debated wrapping the guys in another spell but decided against it. Darnold would need to examine them and my barrier would make that difficult.